Residential and Nursing Care Market Position Statement 2025 - 2040 - Market assessments

Residential Care

Current residential and nursing care capacity and quality has been assessed on the following criteria by adult social care and ICB commissioning leads:

• Market Quality: The rating is defined by the number of residential and nursing providers with their current CQC ratings. Walsall Council aims to use primarily Good or Outstanding providers. The plan is that from 26/27 fee rates will be linked to the quality of provision, with those that are Good or better receiving higher rates than those that have CQC ratings of ‘Requires Improvement’ or below.
• Market Supply: This rating is defined by current demand with existing capacity within each market.
• Market Workforce: This rating is defined by our current understanding of workforce capacity and pressures within bed-based services in Walsall.

Consideration needs to be given to whether there is too much standard residential supply to meet current and future demand and how supply is re-shaped to ensure sustainability of business and services. 

There is currently a potential oversupply of registered residential care homes in the market. There is a need to work with the market to ensure care home provision meets future demand and need, including an increase in nursing care provision and supporting adults with more complex needs later in life.

Local quality assurance intelligence from the Walsall Quality in Care Team reports the following five areas as the top areas of quality concern currently:

1. Organisational abuse
2. Medication errors
3. Falls
4. Supervision
5. Delayed care / treatment

Commissioners and care managers report some lower-level service quality that the specification states; providers sometimes taking packages without having the skills and experience to safely and effectively always manage more complex needs which can result in poorer quality services and outcomes for people in bed-based care. Our ambition is to better support providers to move the dial to amber, with again onto green across all providers to be in line with the Council’s vision. The work is required now to achieve this by ensuring that we have the right providers working in the Borough to deliver good quality residential care.

The stability of the residential care home workforce in Walsall is variable. There is a local workforce in Walsall, but international recruitment issues are currently putting this workforce at some risk.